A Comparative Study of Aluminum Chloride, Oxybutynin Chloride, and Botulinum Toxin in the Treatment of Primary Focal Hyperhidrosis.

BACKGROUND

Primary hyperhidrosis (HH) is a common challenging problem. Different treatment modalities are present with no clear evidence favoring one modality over the others.

OBJECTIVES

To assess and compare the efficacy of aluminum chloride hexahydrate (ACH), oxybutynin chloride, and botulinum toxin type-A (BTX-A) in treating primary focal HH.

PATIENTS AND

METHODS

Sixty-six patients of both sexes, with primary HH, were equally and randomly divided into 3 groups. Group (A) received a single session of intradermal (BTX-A), Group (B) received topical application of ACH lotion 25% once daily, and Group (C) received oral oxybutynin chloride 10 mg daily for 3 months. The clinical response was assessed using the Hyperhidrosis Severity Scale (HDSS) and the patients were followed up for 6 months.

RESULTS

The 3 modalities were effective and safe in the treatment of primary HH, but the clinical response was significantly higher in the BTX-A group (81.8% excellent response) compared to the other 2 modalities. The reduction of hyperhidrosis was also maintained for a longer period in the BTX-A group.

CONCLUSION

Among the 3 modalities, BTX-A was associated with a higher reduction of HDSS scores. A single session was sufficient; however, pain and high cost are limiting factors.